New Resource:

Our Neonatologist just showed me a copy of her "Clinical Pediatrics" of June,
1996.
On Page 283-293 (290-293 list 173 references) they have an article called:
"Special Properties of Human Milk" by Carol L. Wagner, MD, Diane M. Anderson,
Ph.D., RD, and WilliamB. Pittard, III, MD.

"Summary:  In this review, several nutritional and nonnutritive differences
between mothers' milk and formula and their relationship to neonatal
gastrointestinal and immune process are discussed.  The dynamic relationship of
human milk as evidenced by its changing composition, unique bioactive and
immunologic properties, and specialized cellular componenets is further
delineated.  The clinical significance and relevance of these findings to the
clinician  are then presented.  Lastly, educational strategies, their
effectiveness in promoting breastfeeding, and an approach that might be taken by
the clinician to encourage breastfeeding are outlined."

They have some great tables including "Differences between mothers' milk and
formula" , " Immunoportective components of human milk"   "Other Bioactive
sublstances in Human Milk" (Growth factors and cytokines, Hormones,
Miscellaneous) " Aspects of gut function in the early neonatal period affecting
GI tract function"

Best of all, they encourage clinicians to take a proactive approach and after
asking "What type of feeding have you chosen for your infant?" to follow it with
"asking her if she ever considered breastfeeding and why she has elected not to
breastfeed" and :"Even if you choose to feed your baby formula, you might like
to know some of the differences between mothers' milk and formulas."  (Table 5
is An Educational approach regarding breastfeeding").

In addition, they encourage hospital education during the postpartum period.

They encourage education of the nursing staff, housestaff and attending
physicians and ongoing education of patients from the beginning of the prenatal
months rather than waiting for the end.  They encourage early follow-up "by an
experienced nurse" and "anticipatory guidance during the early stages of
lactation".

Missing:  No mention of Postpartum support groups or specialized health care
professionals (LC's).  Still, glad to see all this information so well
documented in a recognized journal.

Jeanette Panchula, BSW, LLLL, IBCLC, LC
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Puerto Rico